The differences in the functional outcomes of subjects who have undergone total knee replacement surgeries in comparison to subjects with normal knees, have been linked to different kinematics between normal knees and the artificial knee replacements. Medial pivot knee replacements incorporate a congruent ball and socket configuration on the medial compartment of the joint which replicates the anatomic configuration of the normal knee joint and thereby allows for natural patterns of motion when installed into a subject. However, medial pivot knee replacements do not have any guiding features to control the motion of the joint into a normal gait pattern because they lack cruciate ligament structures that interconnect the medial condyles in natural knee joints.